1293 Frequency of Serious Illness During 5-Year Period in Office Settings

Abstract

Introduction: When evaluating an ill childpediatritian must be aware of statistics about theoccurence of serious illness, because one of themajor goals of the sick child visit is to identify theseriosly ill child. Serious illness is condition whichrequires the most vigorous therapeutic intervention. Asthma attack belongs to the conditions whereprompt therapy is indicated, when it is moderate tosevere and the main inclusion criteria is cortosteroidtherapy. Serious bacterial infection was defined aspneumonia, sepsis, meningitis, pyelonephritis andosteomyelitis.Methods: We enrolled all sick children reported forpediatric examination,0-14 years old during 5 yearperiod,2005-2009. Retrospective analysis is done. Distribution of sick children was made accordingto final diagnosis and age. Age groups are 0 - 6months,6 - 36 and more than 36 months.Results: We analysed 10319 sick children during 5year period. The total number of seriosly ill patientswas 99(0,96%). The most frequent illness wasacute asthma or bronchiolitis-42(42,42).17 (40%)was 6- 36 monhs aged and 23(54,00%) older than36 months. Serious bacterial illness was foundin 50(50,50%) children.29 children(29,29%) hadpyelonephritis.12(41,37%)was in 6 - 36 months oldgroup and 9(31,03%) were older than 36 months.18patients(18,18%) had pneumonia,8 (44,44%) in6-36 months group and8(44,44%) in more than36 months group. We had only three patients withsepticaemia..Conclusion: Serious illness is very rare in our officebased settings which makes it even more difficult todistinct “really sick” children. Only watchfull followup and rational diagnostic and therapeutic approachcould lead to right decision making.